TITLE: ALS MEDICATION AND EQUIPMENT INVENTORY EMS Policy No. 4102

Transcription

1 PURPOSE: The purpose of this policy is to specify the minimum quantity of equipment and supplies for Advanced Life Support () and/or Transport units in San Joaquin County. AUTHORITY: Health and Safety Code, Division 2.5, Sections & 1798 et seq. DEFINITIONS: A. Advanced Life Support or means any definitive prehospital emergency care role approved by the San Joaquin County EMS Agency, in accordance with state regulations, which includes all of the specialized services listed in H&SC B. Advanced Life Support Ambulance or Ambulance means an emergency ambulance operated by an emergency ambulance provider approved to operate at the level pursuant to a written agreement with the San Joaquin County EMS Agency. C. Ambulance means a vehicle, including aircraft, specially constructed, modified, equipped, or arranged, used or operated for the purpose of transporting sick, injured, convalescent, infirm, or otherwise incapacitated person(s) in the need of medical care. D. Non-Transport Unit or means an non-transport unit operated by a provider approved to operate at the level pursuant to a written agreement with the San Joaquin County EMS Agency. E. Non- Advanced Life Support Ambulance or Non- means an ambulance operated by a non-emergency ambulance provider approved to operate at the level pursuant to a written agreement with the San Joaquin County EMS Agency. F. NA means the provider is not authorized to carry this equipment. G. NR means the provider is not required to carry the equipment, but can at the providers discretion. POLICY: I. Each provider is responsible to develop a daily check out sheet, which shall list all required items listed in this Policy. The provider shall develop an internal Policy that shall require that the attending paramedic complete the check out at the beginning of each shift. II. The attending paramedic on each unit is responsible to ensure that all drugs and equipment are present at the beginning of each shift, all equipment is functioning properly, and that all battery-powered devices are charged. Effective: DRAFT May 13, 2011 Page 1 of 7

2 III. IV. All emergency ambulances, non-emergency ambulances, and non-transport units shall be stocked and equipped as specified in this policy. The quantities specified are minimum quantities except for controlled substances, which are the maximum quantities allowed. V. Expiration dates for medications and supplies must be current, as applicable. All medications, supplies, and equipment shall be stored in accordance with the manufacturer s recommendation. VI. In addition to the items listed below, all ambulances must meet the minimum requirements set forth for ambulances in Title XIII of the California Code of Regulations. Effective: DRAFT May 13, 2011 Page 2 of 7 Medications Activated Charcoal 50 Gm 50 Gm Gm Adenosine 30 mg 30 mg 30 mg Albuterol Aerosolized Solution = 2.5 mg each Aspirin, children s chewable 81 mg tablets 1 bottle 1 bottle 1 bottle Atropine 3 mg 3 mg 6 mg Atrovent (Ipratropium bromide HFA) 0.5 mg each Benadryl 50 mg 50 mg 100 mg Calcium Chloride NR NR 1 gm Dopamine premix NA NR 400 mg Epinephrine 1:1,000 2 mg 2 mg 4 mg Epinephrine 1:10,000 4 mg 4 mg 8 mg Dextrose 50% 25 Gm 50 Gm 75 Gm Glucagon 1 mg 1 mg 2 1 mg Glucose Paste Lidocaine 200 mg 200 mg 400 mg Lidocaine premix NA NR 2 Gm Lidocaine Jelly NA NR 2 oz Magnesium Sulfate NA NR 2 5 Gm Midazolam (Versed) (Must be kept double locked) 10 mg 10 mg 40 mg Morphine Sulfate (Must be kept double locked) 20 mg 20 mg 40 mg Narcan 2 mg 2 mg 4 mg Neosynephrine 0.5 mg per metered dose NA NR 1 bottle Nitroglycerin spray (minimum of 60 metered doses) or 1 bottle 1 bottle 2 bottle Tablet 1/150 gr Normal Saline1000ml bags 3 3 8

3 Saline/Sterile Water 1000ml Irrigating Sodium Bicarbonate meq meq 100 meq Intravenous Supplies & Equipment IV start kit, which contains: (2) Alcohol wipes, (1) Roll tape, 3/4, (2) 2 x 2 gauze sponge, (1) ID label, (1) Providone iodine prep, (1) Adhesive bandage, (1) Latex Free Tourniquet, (1) OpSite Dressing (or equivalent) Disposable razors IV Catheters: 16ga, 18ga, 20ga, 22ga, 2 ea 2 ea 5 ea IV Catheters: 14ga, 24ga 2 ea 2 ea 2 ea Hypo needles 18ga, 20ga/21ga, 22ga/23ga, 25ga 2 ea 2 ea 5 ea Disposable syringes: TB, 3ml, 5ml/6ml, 10ml/12ml 2 2 ea 3 ea Disposable syringes: 20ml/30ml Intraosseous needles: 15ga, & 18ga N/A 1 2 ea 1 2 ea Betadine solution or swabs N/A 2 4 Solution administration set, Macrodrip Solution administration set, Microdrip Blood Y tubing IV extension tubing Saline locks IV Warming device 1 NR 1 Glucose monitoring device with multiple strips Airway Management Supplies & Equipment In ambulance oxygen source, minimum of 500 PSI and a wall mounted regulator 1 NA 1 Portable oxygen D or E size cylinders, minimum of PSI, with regulator Spare Portable oxygen D or E size cylinders, minimum of PSI Continuous Positive Airway Pressure (CPAP) NR NR 1 Wall mount suction device 1 NA 1 Battery powered suction unit Disposable bag valve device adult, with appropriate connector masks Disposable bag valve device pediatric, with appropriate 1 ea 1 ea 1 ea connector masks for children and infants Suction Catheters with control, Fr 6, 8, or 10, 12, or 14, 18 1 ea 1 ea 1 ea Connecting tubing for suction units Yankauer Tonsil Tip Suction Catheter Water soluble lubricating jelly 1 Tube 1 Tube 1 Tube Effective: DRAFT May 13, 2011 Page 3 of 7

4 Oropharyngeal Airways, (adult, child, infant) sizes ea 1 ea 1 ea Nasopharyngeal Airways, Sizes 20, 24, 28, 32, 36 French 1 ea 1 ea 1 ea Nasal Cannula, adult Pediatric Non-rebreather oxygen mask Adult Non-rebreather oxygen mask Nasal Cannula, pediatric Adult laryngoscope handle with lithium batteries alkaline or disposable handles Pediatric laryngoscope handle with lithium batteries alkaline or 2 disposable handles Spare lithium batteries alkaline for laryngoscope handle Macintosh laryngeal blades: #1, #2, #3, #4 1 ea 1 ea 1 ea Miller laryngeal blades: # 0, #1, #2, #3, #4 1 ea 1 ea 1 ea Spare light bulbs for Macintosh laryngeal blades: #1, #2 1 ea 1 ea 1 ea and Miller laryngeal blades: # 0, #1, #2, #3 Spare light bulbs for Macintosh laryngeal blades: #3, #4 1 ea 1 ea 1 ea and Miller laryngeal blades: #4 Magill Forceps Adult and Pediatric 1 ea 1 ea 1 ea Endotracheal tubes: 2.0 or 2.5, 3.0 or 3.5, 4.0 or 4.5, 5.0 or 2 ea 2 ea 2 ea 5.5, 6.0 or 6.5, 7.0 or 7.5, 8.0 or 8.5 Pediatric Stylet 1 ea 1 ea 2 ea ET tube holder Disposable Endotracheal tube introducers Meconium aspirators End tidal CO2 device, quantitative adult 1 ea 1 ea 2 ea End tidal CO2 device, quantitative pediatric 1 ea 1 ea 1 ea Nebulizer mask Breath actuated nebulizer Pleural decompression kit, which includes: 14 or 16 ga 2 to NA ½ inch needle and cannula or patients > 50kg, or 18 ga, 1 to 1 1/4 inch needle and cannula for patients less than 50kg, one-way valve, Betadine swab, tape, and 10 ml syringe, Cricothyrotomy insertion kit, which includes: 10 ml syringe, NA 1 1 Translaryngeal jet ventilator device with push-button and high-pressure tubing with locking device (Adult), or Bag- Valve device (Pediatric), ga needle for adult, ga needle for pediatrics, and Betadine swab, or Enk Oxygen Flow Modulator set, (Adult), or Bag-Valve device (Pediatric), and Betadine swab. Providers are required to have one of the above kits by later than July 1, Combi-Tube SA (Not authorized for use after 12/31/2010) Effective: DRAFT May 13, 2011 Page 4 of 7

5 King Airway LTS-D Size 4 (By no later than 12/31/2010) 1 ea 1 ea 2 ea King Airway LTS-D Sizes 3 & 5 (By no later than 1 ea 1 ea 1 ea 12/31/2010) 60 ML syringe for each King Airway if kit not purchased BAAM NA NR 1 Patient Assessment Supplies & Equipment Soft ankle/wrist restraints 4 NR 4 Stethoscope Penlight Blood pressure cuff: thigh, adult, child, infant 1 ea 1 ea 1 ea Thermometer or equivalent Rolls of tape, size 1 or 2 or 3 Hypoallergenic (Transpore/paper) Bandage shears (heavy duty) Emesis basins 2 NA 2 Covered waste container 1 NA 1 Bed pan/fracture pan 2 NA 2 Urinal 1 NR 1 OB Kit, which includes: (1) pair of sterile gloves, (1) drape sheet, (2) umbilical clamps, (4) disposal towels, (2) O.B. towelettes, (1) bulb syringe, (2) alcohol preps, (1) O.B. sterile pad (1) plastic bag for placenta, (2) twist ties, (1) receiving blanket, (3) gauze sponges, (pk/2) 1000ml Pressure infusion bag or equivalent Broselow Pediatric Resuscitation Tape Cardiac monitor with defibrillation/pacing capabilities 1 1 NA Cardiac monitor with defibrillation/pacing/12 lead capabilities NR NR 1 Pediatric defibrillation equipment ECG electrodes (adult and pediatric) 6 ea 6 ea 9 ea Pulse oximetry device Disposable Blanket Trauma Supplies & Equipment Long board with restraint straps Pediatric immobilization device Head immobilization devices Short extrication device (i.e., KED) 1 ea 1 ea 1 ea Cervical collars Various adult and pediatric or adjustable 2 ea 2 ea 2 ea collars Adult traction splint The use of non-medical tape (i.e., duct tape) is not permitted Effective: DRAFT May 13, 2011 Page 5 of 7

6 Pediatric traction splint Sterile burn sheets Air occlusive dressings x 2 gauze pads Sterile N/A x 4 gauze pads non-sterile Bandage (Compression bandage) Bandage (Compression bandage) Bandage (Compression bandage)8 Abdominal Bandage Rigid splints Short 1 ea 1 ea 2 ea Rigid splints Long 1 ea 1 ea 2 ea Trauma dressings Gauze roll type bandages, size 2 or 4 or Triangular bandages Tourniquet SOF Tactical Tourniquet or the Combat Application Tourniquet (CAT) or equivalent product Instant ice packs Hot Packs NR NR 2 Ringer Cutter NR NR 1 Disaster Supplies Identification Vests - Medical Group Supervisor, Triage Unit Leader NA NR 1 ea START triage tags General Equipment San Joaquin County Map Book (current within 2 years) or MDC s Map book for assigned response zones or district (current within 1 year) or MDC s Battery operated flashlight Operational driver and Passenger seatbelts 2 1 ea 1 ea 1 ea Operational rear seatbelts (jump and bench seats) 3 1 ea 1 ea 1 ea Operational front and rear heat and air conditioning 1 NR 1 Patient compartment door latches operable from inside and outside. Patient sheets 2 NA 4 Patient blankets 2 NA 2 Patient pillows 1 NA 2 2 Seat belts shall be worn at all times while the vehicle is in motion 3 Seat belts shall be worn at all times while the vehicle is in motion Effective: DRAFT May 13, 2011 Page 6 of 7

7 Ambulance gurney with mattress, capable of elevating the 1 NA 1 head and adjustable to several levels. Field Operations Guide ICS (FOG Manual), current edition Mobile or portable radio (s) that are able to communicate on 1 1 NR Med Net, HEAR and Cal Cord, Mobile radios(s) that are able to communicate on Med Net, NR NR 1 HEAR and Cal Cord. Each ambulance shall have at a minimum a speaker and microphone located in the back of the ambulance, which allows the paramedic to communicate with receiving facilities and the base hospital. Required by July 1, 2012 Portable radio(s) that are able to communicate on Med Net, NR NR 1 HEAR and Cal Cord, includes one spare battery per radio Mobile company radio 1 NR 1 Portable company radio, includes one spare battery per 1 NR 1 radio Current San Joaquin County EMS Agency and BLS 1 set 1 set 1 set Policy manual or pocket guide Personal Protective Equipment (PPE) Needle disposal system, which is OSHA compliant Bottle of instant hand sanitizer (alcohol based) Biohazard bags (various sizes recommended) Commercial biohazard spill kit or equivalent Antibacterial disinfectant solution ANSI 107(2004) Class 2 or 3 high-visibility 1 per each crewmember this includes students and interns Personnel protective masks minimum rating N95, fit tested for each crewmember Latex gloves, multiple sizes, in sufficient quantity. Latex free gloves must be available for crewmembers that have allergies to latex Goggles, glasses, or face mask in sufficient quantity Gowns in sufficient quantity Hard hat work helmet Blue one per crewmember, emergency ambulance providers only. Required by May 1, 2011 Optional Equipment Naso/Orogastric tubes (sump tubes) #16 or 18 Naso/Orogastric feeding tubes #10 60 ml Syringe if carrying Naso/orogastric tubes Nasal Atomizer Esophageal detection device (EDD) Blood Y tubing Effective: DRAFT May 13, 2011 Page 7 of 7